Howl-O-Ween Dog Walk Participant Registration

Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email*

example@example.com

Phone Number*

Please enter a valid phone number.

Shirt size*

Dog Size for Bandana*

SmallMediumLarge

My Products*

Family/Single Registration

$40.00 Quantity

Total

$0.00

I release the Germantown K9 Fundraising Organization, any and all supporters and sponsors, directors, employees, agents, board members, and any person connected with the Germantown K9 Fundraising Organization from any liablity or claims of injury or illness that arise during this event or as a result of participating in this event. I understand all risks that are involved in the dog walk. I will pay or assume all financial responsibilty for all medical and emergency expenses in the event of accident or illness regardless of whether I authorize such expenses. I agree to hold harmless the Germantown K9 Fundraising Organization, the walk organizing committee, it's board and directors against all damages, costs, fees, directly or indirectly arising. I also grant full permission without compensation to any and all of the foregoing to use photographic, videotapes, recording or any other record for this event for any legitimate purpose.

Signature*

Payment Methods

Debit or Credit Card

Please click one of the PayPal options to complete payment and submit the form.

Form

Howl-O-Ween Dog Walk Participant Registration